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Cinapsis

Cinapsis - Regional Ophthalmology Service Access

A secure online Referral and A&G platform for Opticians, GPs, other Community based users and NHS and Independent Providers. Supports phone, video and text communication, integrates with NHS patient records and eRS, provides dashboards and referral pathways. Ideal for ICBs and NHS Regions looking to reconfigure Ophthalmology referrals and requests.

Features

  • Secure online Referral and Advice & Guidance/Digital Triage platform
  • Accessible on desktop, tablet, and mobile devices
  • Supports Pathway Redesign with direct access to providers and/or SPOAs
  • Flexible communication options including phone, video and Structured text communication
  • Elective Recovery support that utilises bilateral read/write NHS eRS APIs
  • Gives Opticians access to NHS/Independent Providers and eRS services
  • Secure sharing of DICOM images, documents and other attachments
  • Integrates with Electronic Patient Records, PAS and Optometry Systems
  • Sends Patient Questionnaires, image requests and patient letters via SMS
  • Data sharing enabled by NHS PDS Spine Lookup and GPConnect

Benefits

  • Reduces avoidable outpatient attendances
  • Empowers teams to manage large volumes of referrals quickly
  • Customised pathways ensures high quality of referrals and requests
  • Reduced waiting time associated with Optometry/GP referral handover
  • Enables viewing/assessment of Full Volumetric OCT scans
  • Allows more patients to be managed in community based settings
  • Reduces Elective Recovery backlogs and shortens patient waiting times
  • Makes reporting and monitoring simple
  • Pathways designed as required e.g. Glaucoma, Cataract, Wet AMD
  • Enables patients to be more informed, involved and empowered

Pricing

Service documents

Request an accessible format
If you use assistive technology (such as a screen reader) and need versions of these documents in a more accessible format, email the supplier at sales@cinapsis.com. Tell them what format you need. It will help if you say what assistive technology you use.

Framework

G-Cloud 15

Service ID

8 3 8 5 5 1 4 6 1 2 9 8 2 0 5

Contact

Cinapsis Dr Owain Rhys Hughes
Telephone: 0203 858 0124
Email: sales@cinapsis.com

About your service

Service categories

Applications

Production and operations

Service industry and public sector operations

  • Healthcare
Multi cloud support
No

Service scope

Software add-on or extension
No
Cloud deployment model
Public cloud
Service constraints
There are no service constraints.
Buyers and users can utilise their own hardware and access Cinapsis from any internet facing device and therefore are not constrained by a requirement to access the HSCN or use Cinapsis provided hardware.
System requirements
  • Utilisation of a modern browser
  • We advise the latest or previous IOS version
  • We advise the latest or previous Android OS version
  • For data upload, we require 3G/4G/5G, WiFi or Network Connection

User support

Email or online ticketing support
Yes
Support response times
Our SLA details our response times. Our initial response is 15 minutes for problems and 1 day for questions.
User can manage status and priority of support tickets
No
Phone support
Yes
Phone support availability
9 to 5 (UK time), 7 days a week
Web chat support
Yes
Web chat support availability
9 to 5 (UK time), 7 days a week
Web chat support accessibility standard
WCAG 2.2 AA
Web chat accessibility testing
We conduct usability testing of our web chat functionality with assistive technology users to support compliance with WCAG 2.2 AA.

Testing includes users of screen readers, keyboard-only navigation, and other accessibility features to assess all aspects of interaction with our users of our web chat feature.

Feedback from this testing is documented and used to improve accessibility and usability of the user experience.

All issues are recorded, tracked and addressed through our standard development and release processes.
Onsite support
Yes, at extra cost
Support levels
Support is provided 9am - 5pm, 7 days a week excluding bank holidays. Users will often be signposted toward digital support channels, rather than telephone calls to ensure that all users receive a prompt response and resolution.
The Cinapsis system is monitored 24/7/365 and any major system issues identified and resolved.
All support related tickets are investigates and resolved without charge.
Requests for system enhancements are taken seriously and often applied without charge to the customer.
Cinapsis reserves the right to consider all requests and on occasions may determine that a one-off development fee be applied to cover the cost of the change.
Should on-site training or support for problems not relating to Cinapsis e.g. infrastructure, we will create a quotation to be agreed before any investigative work is undertaken.
All customers have access to customer support and a nominated Customer Success Manager to resolve issues quickly and ensure that benefits for using Cinapsis are maximised.
Support available to third parties
Yes
AI chatbot
No

Onboarding and offboarding

Getting started
We use blended online and face to face training, that facilitates quick understanding and uptake of all aspects of the system including case creation, response and completion of cases, undertaking reporting, all administration of the system and how to identify and resolve any issues.

We use PRINCE2 project management process and a RACI Matrix to deliver efficient Onboard Training. Training support is available 24/7 informed by local Training Needs Analysis undertaken during mobilisation so we can ensure rapid training of new users to a high-level of competence.

A comprehensive knowledgebase of articles and e-Learning Portal featuring articles & Get Started videos are also available and easily accessible for all registered users.
Service documentation
Yes
Documentation formats
PDF
End-of-contract data extraction
We offer a bulk extraction of information at the end of the contract. This includes all data items within the system. It is available in a JSON format which can be sent via API, SFTP or other (e.g., FTPS, AS2, HTTPS, or MFT).

The data extraction process is agreed upon signing of the contract and reviewed periodically between the parties.
End-of-contract process
There are no additional charges applied at the end of the contract. All data extracts and any required deletion of data is included in the contract price.

Should an extension be required, this charge will be made clear within the contract.
Documentation accessibility standard
WCAG 2.2 AA

Using the service

Web browser interface
Yes
Supported browsers
  • Microsoft Edge
  • Firefox
  • Chrome
  • Safari
  • Opera
Application to install
Yes
Compatible operating systems
  • Android
  • IOS
  • Windows
Designed for use on mobile devices
Yes
Differences between the mobile and desktop service
All functionality is available on all devices (IOS, Android and Windows). Users have a choice of which applications and devices they wish to use to access Cinapsis.
The only differences are those required to adapt the user experience to the native user interface that each operating system provides and to render the data appropriately in accordance with screen size.
Service interface
Yes
User support accessibility
WCAG 2.2 AA
Description of service interface
Cinapsis displays data within a modern interface and maximises the ability to show relevant and appropriate data to the users.
Accessibility standards
WCAG 2.2 AA
Accessibility testing
We have conducted comprehensive system testing with staff who fully understand the needs of this assistive technology.

Upon initial design and when any system changes are applied, we undertake usability testing with users who rely on assistive technologies such as screen readers, keyboard-only navigation, and accessible display settings. Findings from these sessions are documented and used to remediate accessibility issues.

Testing is supplemented with automated accessibility tools and manual assessments mapped to WCAG 2.2 AA success criteria. Accessibility issues are tracked and addressed through our regular development, testing and release processes to support ongoing compliance.

This approach ensures our commitment and compliance to meet WCAG 2.2 AA standards.
API
Yes
What users can and can't do using the API
All API management and application of the available options are activated and amended by the Cinapsis implementation and support teams. Users do not need to set up or make any changes themselves to the API or it's settings.
Our HL7/FHIR APIs integrate with a host of systems. When new use cases are established, we manage these relationships and apply any required development in partnership with the necessary third party providers.
API documentation
Yes
API documentation formats
Other
API sandbox or test environment
Yes
Customisation available
Yes
Description of customisation
Subject to RBAC permissions established with the Cinapsis implementation or support teams Users are able to customise:
Users and access levels,
Patient Questionnaires,
Data input forms,
Pathway requirements,
Set minimum data requirements,
Reporting requirements,
Data extract options,
Clinical outcomes,
eRS integration
Integration into Optometry patient records systems

Scaling

Independence of resources
We ensure users are not impacted by demand created from other user activity by careful capacity planning, workload isolation, and proactive monitoring.
The service is hosted on dedicated infrastructure with defined resource limits to prevent any single user or process from degrading overall performance. Usage and performance are continuously monitored, and thresholds are in place to identify increased load or degradation early.
Critical components are isolated to prevent “noisy-neighbour” issues, and we regularly review usage patterns to plan capacity ahead of demand. This approach ensures consistent performance and availability for all users with uptime performance exceeding 99.99%

Analytics

Service usage metrics
Yes
Metrics types
Reporting metrics can be defined into two categories; operational and statistical reporting.
Operational reports include; Time taken to complete reports, reports showing if/when cases have not been fully completed, eRS and other integration issues, rota management issues.
Analytical reports include; requester and provider case volumes, outcomes analysis, usage reports, cumulative and trend analysis, average time reports and cross ICB area activity analysis.
Reporting types
  • API access
  • Real-time dashboards
  • Regular reports
  • Reports on request
Resource tagging
No
FOCUS resource tagging
No

Resellers

Supplier type
Not a reseller

Staff security

Staff security clearance
Conforms to BS7858:2019
Government security clearance
Baseline Personnel Security Standard (BPSS)

Asset protection

Knowledge of data storage and processing locations
Yes
Data storage and processing locations
United Kingdom
User control over data storage and processing locations
No
Datacentre security standards
Complies with a recognised standard (for example CSA CCM version 4.0)
Penetration testing frequency
At least once a year
Penetration testing approach
‘IT Health Check’ performed by a CREST-approved service provider
Protecting data at rest
Physical access control, complying with CSA CCM v4.0
Data sanitisation process
Yes
Equipment disposal approach
Complying with a recognised standard, for example CSA CCM v4.0, CAS (Sanitisation) or ISO/IEC 27001
Data sanitisation type
  • Deleted data can’t be directly accessed / Cryptographic Erasure
  • Data Erasure

Data importing and exporting

Data export approach
Users can export their data by manually creating reports. Automated reports can be generated and ran according to a pre-defined schedule.

Reports can be sent via secure email, MESH, SFTP, HSCN, or Data Landing Portal and include a wide variety of data aspects and include / exclude patient identifiable information (subject to user access rights).
Data export formats
CSV
Data import formats
CSV

Data-in-transit protection

Data protection between buyer and supplier networks
TLS (version 1.2 or above)
Data protection within supplier network
TLS (version 1.2 or above)

Availability and resilience

Guaranteed availability
System availability is guaranteed at 99.9%.

Should system availability drop below this figure, for each 24 hours of accumulated downtime, buyers are entitled to 1/365 service credit of the annual licence fee.
Approach to resilience
This information is available on request.
Outage reporting
Cinapsis maintains a status page via a public facing URL.

This shows both the current and historic status and whether any degradation of system performance (including any individual system element) is or has occurred.

Key users and contacts will also be automatically advised by email should a major system issues or failure occur.

System degradation or failure is so rare that there is not, nor has there ever been a requirement or request for users to be advised via an API.

Identity and authentication

User authentication needed
Yes
User authentication
  • Multi-Factor Authentication (MFA)
  • Username or password
Access restrictions in management interfaces and support channels
Access to management and administrative interfaces is tightly controlled using multiple layers of security:
Users are granted the minimum permissions required for their role using RBAC controls.
Only users directly involved with patient care can view and identify patient level data.
All administrative access requires strong passwords and two-factor authentication.
Access is provisioned and removed through a centralised or localised administrative portal, with regular access reviews enabled.
Audit logging: All administrative actions are logged and monitored to support traceability and incident investigation.
Access can be time-bound and approved, with automatic expiry when required.
Access restriction testing frequency
At least once a year
Management access authentication
  • Multi-Factor Authentication (MFA)
  • Username or password

Audit information for users

Access to user activity audit information
Users have access to real-time audit information
How long user audit data is stored for
At least 12 months
Access to supplier activity audit information
Users contact the support team to get audit information
How long supplier audit data is stored for
At least 12 months
How long system logs are stored for
At least 12 months

Security governance

Named board-level person responsible for service security
Yes
Security governance certified
Yes
Security governance standards
CSA CSM version 4.0
Information security policies and processes
We maintain a comprehensive information security policy that is designed to protect the confidentiality, integrity, and availability of information. These are aligned to recognised industry standards and best practices (for example ISO 27001) and are reviewed and updated regularly.

Key elements of our program include secure system and network architecture; strong access controls based on least privilege and multi-factor authentication, encryption of data in transit and at rest; and secure software development practices.

We operate defined operational security processes, including employee security training, third-party risk management, continuous monitoring and logging, vulnerability management, and regular security testing.

We also maintain documented incident response, business continuity, and disaster recovery procedures. These are periodically tested to ensure staff understanding, readiness and compliance with procedures.

Independent assessments and audits are also used to validate controls, compliance and drive continuous improvement.
Software Security Code of Practice
Yes

Operational security

Configuration and change management standard
Supplier-defined controls
Configuration and change management approach
All components are identified and tracked using version control systems.
Full version history, ownership, and change attribution.
Development, testing, and production environments are clearly separated, with distinct configurations and access controls.
Changes are deployed through automated processes to ensure consistency and reduce errors made possible by manual intervention.
Components are tracked from initial design and deployment through updates, deprecation, and retirement.
All changes are tested and reviewed prior to deployment.
Changes are assessed for potential security impact, including:
impact on authentication, authorisation, or access controls
exposure of data or network boundaries
introduction or update of third-party dependencies
Vulnerability management type
Complies with a recognised standard, for example CSA CCM v4.0 or SSAE-18 / ISAE 3402
Vulnerability management approach
We maintain a proactive vulnerability management process to identify, assess, and remediate security risks across our services.
Potential threats are assessed using automated vulnerability scanning, dependency analysis, threat modelling, and risk-based prioritisation based on severity, exploitability, and impact. We monitor trusted sources including vendor security advisories, public vulnerability databases (e.g. CVE/NVD), automated security tools, threat intelligence feeds, and responsible disclosure reports.
Patches are deployed according to defined timelines: critical vulnerabilities are addressed as quickly as possible (typically within 24-72 hours), high-severity issues within days, and lower-risk issues during regular maintenance cycles.
Protective monitoring type
Supplier-defined controls
Protective monitoring approach
Cinapsis utilises continuous monitoring to detect and respond to security incidents.
Systems have been installed to ensure that data and activity is monitored for indicators of compromise. These include but are not limited to deletion of data, and unusual user or network activity.
Alerts are issued to staff who investigate incidents and ensure rapid action including correction of incidents will follow. All incidents are documented using documented standard operating procedures.
High-severity incidents are prioritised, with initial response typically occurring in less than an hour depending on the risk and impact to the Cinapsis service.
Incident management type
Supplier-defined controls
Incident management approach
We maintain a formal, documented incident management process designed to ensure the timely identification, response, resolution, and communication of security and service incidents.
Users can report incidents via webchat, email, or a direct call. Incidents are triaged by our support team and handled in accordance with the defined incident priority and response procedures.

Incidents are managed by our experienced engineering team and problems resolved within agreed SLAs.

Our incident management processes are ITIL compliant. Information relating to logged incidents are available for users to view 24/7/365.

These show the status, incident-ID, requester, responder, last activity and outcome of each incident.
Post-quantum cryptography secure
Yes

Secure development

Approach to secure software development best practice
Conforms to a recognised standard, but self-assessed

Public sector networks

Connection to public sector networks
Yes
Connected networks
Health and Social Care Network (HSCN)

Pricing

Discount for educational organisations
No
Free trial available
No

Discount percentage by annual call-off contract value (excluding VAT)

Less than £250,000
0%
Between £250,000 and £500,000
0%
Between £500,001 and £1,000,000
0%
Between £1,000,001 and £2,500,000
0%
Between £2,500,001 and £5,000,000
0%
Over £5,000,001
0%

Non-mandatory Standards and certifications

ISO/IEC 27001 certification
No
ISO 28000:2022 certification
No
ISO 9001 certification
No
Quality management systems (QMS)
Yes
CSA STAR certification
No
PCI certification
No
Cyber essentials
No
Cyber Essentials Alternative
None of the criteria
Cyber essentials plus
Yes
Please provide your Cyber Essentials Plus Certificate Number
5c502ec6-af72-4ef8-af91-4a2bd5ffcc82
Other security certifications
No

Social value

Section B - Commitment for Future: Delivery
  • Mission: Kick start economic growth. To secure the highest sustained growth in the G7 - with good jobs and productivity growth in every part of the country making everyone, not just a few, better off.

    Policy Outcome 1: Fair work: That offers fair wages and good working conditions. Help people get a job, stay in work, and progress in their careers, with good employment opportunities across the country. Notes: Where there is a large proportion of labour costs in the contract, commercial teams should consider MAC in Outcome 1 as a priority

    • New or retained jobs on the contract workforce in the relevant area that meet the criteria set out in MAC 1b, 1c and 1d
    • New apprenticeships on the contract workforce in the relevant area that meet the criteria set out in MAC 1b
    • Providing opportunities for, and measuring and monitoring of, staff workforce conditions over time, including employee engagement, involvement in decision-making and satisfaction and adapting to any changes in the results, with clear processes for acting on issues identified
    • Plans to engage the contract workforce in deciding the most important workplace issues to address
    • Ensuring new workers are informed of their right to join a trade union
    • Monitoring of employee engagement rates (by protected characteristic) and, where necessary, the development of actions to ensure all voices are heard across the diversity of the workforce
    • Employment contracts that reflect actual hours worked; steps taken to ensure employees understand their contracts and have the ability to review and adjust them if actual hours regularly exceed contracted hours
    • Activities that support an environment where staff are educated about, and feel empowered to, address their physical wellbeing
    • Activities that support an environment where staff are educated about and feel empowered to report and address bullying and harassment
    • Activities to cascade good practice on fair working conditions throughout the supply chain
    • Offer a pay and leave entitlement to all eligible staff who become kinship carers, ideally equivalent to statutory adoption pay and leave
    • Payment of more than the National Minimum Wage or National Living Wage (as appropriate) to the contract workforce
    • Monitoring and reporting of gender and ethnicity pay gaps and plans to address them where necessary
    • Entitlement to sick pay for the contract workforce, with provision in place for any staff who do not meet the earnings threshold for statutory sick pay, payment of sick pay from day one of absence and payment of staff on the contract workforce who are off sick a replacement income of 100% of their usual earnings for as long as possible
    • Plans for an appropriate income replacement policy for staff who are required to spend time away from work to care for a sick dependent or close relative
    • Understanding of in-work progression issues affecting the market, industry or sector relevant to the contract, and in the supplier’s own organisation and those of its key sub-contractors
    • Measures to support in-work progression to help people in the contract workforce, to move into higher paid work by developing new skills relevant to the contract
    • Support for the contract workforce by providing career advice, and providing opportunities for staff working on the contract with in-work progression career development into known skills shortages or high growth areas
    • Support for educational attainment relevant to the contract, including training schemes that address skills gaps and result in recognised qualifications
    • Volunteering opportunities for staff
    • Understanding of the modern slavery risks and issues affecting the market, industry, sector or country (of origin or of source) relevant to the contract, and the workforce in the supplier’s own organisation and those of its key subcontractors
    • Measures to identify, mitigate and manage modern slavery risks relating to the contract and how these will be implemented
    • Outline policies and practices to be applied to or put in place for the contract to mitigate and manage modern slavery risks, including: Pre-employment checks, recruitment practices. Workplace conditions, safeguarding plans and processes in place and regular monitoring with relevant groups considered, which may include sampling
    • How these flow down the supply chain and are monitored Illustrative examples include reporting, site visits, audits, etc.
    • How to ensure business decisions re: price/cost, short lead times, payment timescales do not create modern slavery risks in the supply chain
    • How the supplier will work with NGOs, trade unions or other businesses to address modern slavery risk
    • Means of influencing staff, suppliers, customers, communities and/or any other appropriate stakeholders with respect to modern slavery risks relating to the contract
  • Mission: Kick start economic growth. To secure the highest sustained growth in the G7 - with good jobs and productivity growth in every part of the country making everyone, not just a few, better off.

    Policy Outcome 2: Skills for growth: Supporting growth sectors and addressing skills gaps.

    • Understanding of employment and relevant skills issues, and of the education and training issues relating to the contract. Illustrative examples: demographics, skills shortages, new opportunities in high growth sectors, geographic/local community and skills/employment challenges
    • Support for educational attainment relevant to the contract, including training schemes that address skills gaps and result in recognised qualifications
    • Activities to support relevant sector related skills growth and sustainability in the contract workforce. Illustrative examples: careers talks, curriculum support, literacy support, safety talks and volunteering
    • Delivery of apprenticeships, supported internships and T Level industry placement opportunities (Level 2, 3 and 4+) in relation to the contract
  • Mission: Kick start economic growth. To secure the highest sustained growth in the G7 - with good jobs and productivity growth in every part of the country making everyone, not just a few, better off.

    Policy Outcome 3: Resilient, innovative and flexible supply chains: Support economic growth through enabling resilient businesses, opportunities for small businesses and voluntary, community and social enterprises

    • Understanding of the types of businesses in the market and the level of participation by new businesses, entrepreneurs, start-ups, SMEs, VCSEs and mutuals
    • Activities to identify opportunities to open up sub-contracts under the prime contract to a diverse range of businesses, including new businesses, entrepreneurs, start-ups, SMEs, VCSEs and mutuals
    • Plans for engaging a diverse range of businesses in engagement activities prior to appointing subcontractors (including activities prior to award of the main contract and during the contract term)
    • Activities that demonstrate a collaborative way to work with a diverse range of businesses as part of the supply chain
    • Advertising of supply chain opportunities openly and to ensure they are accessible to a diverse range of businesses, including advertising all subcontracting opportunities on Contracts Finder
    • Understanding of local demographics, needs and opportunities for the co-design of the goods, services and works to be delivered under the contract
    • Measures to involve local stakeholders and/or users in design (e.g. in the design of services, systems, products or buildings)
    • Plans to respond flexibly and adapt approaches to community engagement and initiatives
  • Mission: Make Britain a clean energy superpower: To cut bills, create jobs and deliver security with cheaper, zero-carbon electricity by 2030, accelerating to net zero

    Policy Outcome 4: Sustainable procurement practices: Reducing carbon footprints, minimising waste, and promoting the use of clean energy and green technologies.

    • Understanding of opportunities for additional environmental benefits delivery in the performance of the contract, including working towards net zero carbon emissions and use of clean energy and green technologies
    • Collaborative ways of working with the supply chain to deliver additional environmental benefits in the performance of the contract, including working towards net zero carbon emissions and use of clean energy and green technologies
    • Delivery of additional environmental benefits through the performance of the contract, including working towards net zero carbon emissions and use of clean energy and green technologies
    • Understanding of how to influence staff, suppliers, customers, communities and/or any other appropriate stakeholders through the delivery of the contract to support climate and nature protection and improvement
    • Activities to reconnect people with the environment and increase awareness of ways to protect and enhance it
  • Mission: Break down barriers to opportunity: By reforming our childcare and education systems, to make sure there is no class ceiling on the ambitions of young people in Britain

    Policy Outcome 6: Employment and training: For those who face barriers to employment

    • Understanding of employment and skills issues, and of the skills and employment shortages of high growth sectors relating to the contract
    • Creation of employment opportunities particularly for those who face barriers to employment, such as prison leavers, care leavers and/or who are located in deprived areas, and for people in industries with known skills shortages or in high growth sectors
    • Delivery of training schemes and programmes to address any identified skills gaps and under-representation in the workforce for the contract (e.g. prison leavers, care leavers, kinship carers, disabled people)
    • Working conditions which promote an inclusive working environment and promote retention and progression
    • Understanding of the issues affecting inequality in employment, skills and pay in the market, industry or sector relevant to the contract, and in the supplier’s own organisation and those of its key sub-contractors. Measures to tackle inequality in employment, skills and pay in the contract workforce
    • Inclusive and accessible development practices, including guidance for line managers on recruiting, managing and developing people with a disability or health condition
  • Mission: Break down barriers to opportunity: By reforming our childcare and education systems, to make sure there is no class ceiling on the ambitions of young people in Britain

    Policy Outcome 7: Creating a pipeline of opportunities: For the contract workforce, reducing barriers to entry for under-represented groups.

    • Understanding of the issues affecting the development of new skills by target cohort
    • Other measures to offer development opportunities for the target cohort(s) in the contract workforce
    • Understanding of issues relating to entering the contract workforce
  • Mission: Build an NHS fit for the future: That is there when people need it; with fewer lives lost to the biggest killers; in a fairer Britain, where everyone lives well for longer.

    Policy Outcome 8: Increasing productivity through physical and mental wellbeing: In the supply chain and communities in the relevant area.

    • Understanding of issues relating to health and wellbeing, including physical and mental health, in the contract workforce
    • Understanding barriers to access to health and social care services or employment opportunities e.g. digital inclusion
    • Inclusive and accessible recruitment practices, development practices and retention policies that support-focused activities including those provided in the Guide for line managers on recruiting, managing and developing which support people with a disability or health condition
    • Actions to invest in the physical and mental health and wellbeing of the contract workforce

Service documents

Request an accessible format
If you use assistive technology (such as a screen reader) and need versions of these documents in a more accessible format, email the supplier at sales@cinapsis.com. Tell them what format you need. It will help if you say what assistive technology you use.